Medicaid expansion | St. Louis Public Radio

Medicaid expansion

A voter fills out a ballot at Central Baptist Church on March 10, 2020.
File photo | Carolina Hidalgo | St. Louis Public Radio

Updated at 9 p.m. with lawsuit filed against the initiative

Missouri Gov. Mike Parson announced Tuesday that the question of whether to expand Medicaid will be placed on the August primary ballot, a move he said is more about policy than politics. 

Parson said that expanding Medicaid to insure more low-income people will be a “massive spending initiative” and that the state needs to know where it stands financially. 

A voter fills out a ballot at Central Baptist Church in St. Louis on March 10, 2020.
File photo | Carolina Hidalgo | St. Louis Public Radio

Missouri voters will get a chance to expand Medicaid.

Secretary of State Jay Ashcroft announced Friday that he approved the petition to put Medicaid expansion on the November ballot.

Backers submitted more than 340,000 petition signatures, well over the number needed to qualify for a proposed constitutional amendment.

The amendment would expand Medicaid to people making 138% of the federal poverty level, which is a little less than $18,000 a year.

A bid to expand Medicaid has received substantial amounts of monetary and organizational supporter over the past few months.
File photo I Carolina Hidalgo I St. Louis Public Radio

Coronavirus concerns have made gathering signatures for ballot items basically impossible, especially with state and local governments placing restrictions on public gatherings.

But a group seeking to put a Medicaid expansion proposal before Missouri voters says it started early enough to get the necessary signatures for the 2020 ballot.

Illinois Gov. J.B. Pritzker annouced he would expand Illinois Medicaid becuase of the coronavirus outbreak at a press conference on March 18, 2020.
Eric Schmid | St Louis Public Radio

BELLEVILLE — Illinois Gov. J.B. Pritzker announced he filed for a federal waiver to expand Medicaid coverage for COVID-19 illnesses in the state at a press conference on Wednesday.

“We’re working both with the insurance companies as well as with Medicaid with the federal government to try and make sure everything around COVID-19 is covered,” he said. “So that nobody has to go without treatment for a [coronavirus]-related illness.” 

Kip Kendrick and Martha Stevens
Jason Rosenbaum | St. Louis Public Radio

Missouri state Reps. Kip Kendrick and Martha Stevens, both Democrats from Columbia, appeared on Politically Speaking to talk about Medicaid expansion, the possible repeal of Clean Missouri and other topics.

Both Kendrick and Stevens support the Medicaid expansion initiative that is expected to appear on the ballot later this year. 

Kendrick and Stevens said they don’t think Medicaid expansion will cost the state as much money as Republican opponents have suggested. Stevens said adopting Medicaid expansion could save the state money in the long run because the federal government pays a larger portion of the bill. 

A sign announces the sudden closure of Pinnacle Regional Hospital in Boonville.
SEBASTIAN MARTINEZ VALDIVIA | KBIA

When Pinnacle Regional Hospital in Boonville closed recently, it became the seventh rural hospital to shut its doors in Missouri since 2010.

In that same time frame, Illinois had two rural hospitals go out of business. The National Rural Hospital Association blames the difference on lack of Medicaid expansion. 

The association reports there are nine factors that can lead to a rural hospital shutting down, and being in a state, like Missouri, that hasn't expanded Medicaid is No. 1.

Quade in healthcare press conference on Monday, Jan. 27, 2020
Tim Bommel | Missouri House Communications

Democrats in the Missouri House say they’re confident voters will approve Medicaid expansion, and they want to strengthen other health care measures in 2020. 

In a press conference Monday, House Minority Leader Crystal Quade, D-Springfield, said the need for Missouri to expand Medicaid is vital, despite Republican efforts to kill the idea. 

“Since 2014, no fewer than seven rural hospitals have closed,” Quade said, “in no small part because the governor and Republicans have refused to expand Medicaid.” 

Missouri House of Representatives members speak on the house floor on the last day of the legislative session.
File photo I Carolina Hidalgo | St. Louis Public Radio

On the latest episode of Politically Speaking, St. Louis Public Radio’s Julie O’Donoghue, Jaclyn Driscoll and Jason Rosenbaum look at what lies ahead for Missouri legislators in 2020.

Lawmakers are returning Wednesday to Jefferson City, where they’ll spend more than five months piecing together Missouri’s budget and dealing with a host of contentious issues.

Members of the Missouri House converse on the first day of the 2019 legislative session.
File photo | Jason Rosenbaum I St. Louis Public Radio

Gun control, Medicaid and redistricting are expected to be the most contentious issues Missouri lawmakers will take up this legislative session. 

House and Senate members return to the state Capitol on Wednesday, and the governor is to deliver his State of the State address a week later on Jan. 15. 

Democrats in both chambers say gun control and urban violence will be at the top of their list of priorities. 

For sickle cell patients, opioids are often the only pain relief. But growing rates of addiction among the general public mean emergency room doctors are more cautious than ever in prescribing those powerful medications, causing challenges.
File photo | Carolina Hidalgo | St. Louis Public Radio

The petition to put a Medicaid expansion in Missouri to a statewide vote has garnered more than 25% of the needed signatures to place the measure on the November 2020 ballot, according to campaign officials.

The effort to extend eligibility for the state-sponsored health insurance program to those making up to $18,000 a year also has received support from several high-profile state organizations, including Washington University and BJC HealthCare.

State Rep. LaDonna Appelbaum, D, St. Louis County
Jason Rosenbaum I St. Louis Public Radio

St. Louis Public Radio’s Julie O’Donoghue and Jaclyn Driscoll welcome state Rep. LaDonna Appelbaum to Politically Speaking for the first time. The discussion includes the Democrat's efforts to improve health care.

Appelbaum represents Missouri’s 71st House District, which takes in portions of Chesterfield, Creve Coeur, Maryland Heights, Olivette, Overland and unincorporated St. Louis County. She was first elected in 2018.

Tim McBride
Julie O'Donoghue I St. Louis Public Radio

Tim McBride is the latest guest on Politically Speaking. The Washington University professor talked with St. Louis Public Radio’s Julie O’Donoghue and Jaclyn Driscoll about the prospect of Medicaid expansion.

McBride headed the board that oversaw Missouri’s Medicaid program until he was replaced earlier this year. At Wash U, he focuses on health care policy. 

Patricia Powers went a few years without health insurance and was unable to afford regular doctor visits. So the Missouri resident, who lives near St. Louis, had no idea that cancerous tumors were silently growing in both of her breasts.

Sen. Bill Eigel, R-Weldon Spring, is a member of the six-person Conservative Caucus.
File photo I Carolina Hidalgo | St. Louis Public Radio

Sen. Bill Eigel is the latest guest on Politically Speaking, where he talked with St. Louis Public Radio’s Jason Rosenbaum, Julie O’Donoghue and Jaclyn Driscoll about the future of the Conservative Caucus in the Missouri legislature.

The St. Charles County Republican is a member of a six-person Senate faction that has questioned GOP proposals involving transportation spending and economic development.

Sen. Lincoln Hough, R-Springfield
File photo I Carolina Hidalgo | St. Louis Public Radio

Sen. Lincoln Hough is the latest guest on the Politically Speaking podcast. The Springfield Republican talked with St. Louis Public Radio’s Jason Rosenbaum and Jaclyn Driscoll about the upcoming special session — and what to expect when lawmakers come back to Jefferson City in January.

Hough represents Missouri’s 30th Senatorial District, which takes in a big chunk of Springfield and Greene County. He was sworn into office in early January for a four-year term.

In his hospital room at Touchette Regional Hospital in Centreville, patient Steven Glispie finishes signing the paperwork to enroll in Medicaid.
File photo | Véronique LaCapra | St. Louis Public Radio

Proponents of a Medicaid expansion in Missouri want to allow voters to override the state's Republican leaders, who have refused to extend coverage to more people.

The Healthcare for Missouri coalition is collecting signatures on a petition that would place a Medicaid expansion on the November 2020 ballot. If approved by voters, Missouri would expand the health insurance program to those who earn up to $18,000 a year. Missouri is one of 14 states that has not made the program available to more low-income people.

Campaign organizers say the expansion is necessary to extend health care coverage to people who have jobs but lack health insurance.

Governor Mike Parson signed an executive order earlier this summer creating a task force to look into something that could bring big changes to how Missourians get—and pay for—their health care. 

A kit containing the opioid overdose antidote naloxone.
File Photo | Camille Phillips | St. Louis Public Radio

The number of drug-related deaths increased by 16% last year, as fatal overdoses declined by an estimated 5.1% nationwide, according to the Centers for Disease Control and Prevention.

Missouri is one of 17 states that saw a rise in drug-related deaths last year. In 34 states, the number of deaths declined. Only Delaware had a higher increase over the previous year, at 16.7%.

Keith Carter, 53, waits to pick up a prescription for diabetes at Affinia Healthcare in St. Louis. Though he falls in the income gap, he's able to get his preventive care covered through Gateway to Better Health.
Durrie Bouscaren | St. Louis Public Radio

Missouri likely would not have to spend any additional money to expand Medicaid to insure more low-income people, according to a report from the Washington University Center on Health Economics and Policy.

The state spends nearly $4 billion to provide Medicaid to people with disabilities, pregnant women, children and some seniors.

Researchers say adding people who make up to 138 percent of the federal poverty rate – close to $17,000 annually – likely wouldn’t cost Missouri extra funds, because the state would receive increased federal funding under a Medicaid expansion.

Health care advocates in Kansas and Missouri are hopeful that 2019 will be the year that hundreds of thousands of people can get health care coverage through expansion of Medicaid.

It’s been blocked in both states by Republicans who question the price tag, but now that many states have had expanded Medicaid for several years, there’s a small but growing body of evidence about its actual costs.

One of the first signs drivers see on the way into Unionville, Missouri, is this billboard advertising cardiology at Putnam County Memorial Hospital, a hospital in northern Missouri.
Bram Sable-Smith | Side Effects Public Media

Rural hospitals are more likely to close in states such as Missouri that have not expanded Medicaid.

A recent report from the pro-Affordable Care Act organization Protect Our Care analyzed 84 rural hospital closures since 2010. It found 90 percent of those hospital closures were in states that had not expanded Medicaid coverage. Missouri remains one of the 14 states that hasn’t amended its program to cover people who earn up to 138 percent above the poverty line.

Missouri and Kansas have joined 18 other states in seeking to have the Affordable Care Act declared unconstitutional following Congress’ repeal last year of the tax penalty associated with the individual mandate.

In a lawsuit filed late Monday in federal court in Texas, the coalition of 20 mostly red states claimed that the elimination of the tax penalty for those who don’t buy health insurance renders the entire healthcare law unconstitutional.

Lacy Seward, social services coordinator for the Monroe City Manor. Medicaid cuts proposed by Senate Republicans could hit hard in this small town, that helped vote them into office.
Durrie Bouscaren | St. Louis Public Radio.

MONROE CITY, MO. — The closest emergency room is 20 miles east on the highway. That’s why it isn’t unusual for people experiencing heart attacks, blood clots and strokes to show up at Dr. Rodney Yager’s clinic on Main Street in Monroe City.

Yager, who grew up in the area, can handle the fast pace of a small-town clinic. What worries him more is how federal health care policies being shaped in Washington, D.C., could affect his patients.

David Mueller, 31, picks up his three-year-old daughter Marjorie from daycare on May 4, 2017. She has a rare form of cystic fibrosis, and Mueller worries the Republican health plan will affect the family's ability to pay for her care.
Durrie Bouscaren | St. Louis Public Radio.

A Republican proposal to gut the Affordable Care Act narrowly passed the U.S. House of Representatives and now the U.S. Senate is crafting its own bill to reshape the nation’s health care system. Elected officials have held few town halls to hear from constituents in the St. Louis area about what they want in a health care bill, sparking demonstrations outside representatives’ offices.

Drive down a dirt road in Dallas County, under a thick canopy of walnut trees and over three cattle guards, and you’ll come to Rachel Harrison’s home in Windyville, Missouri.  

A few years ago, Harrison was using her Bachelor’s degree in biology in a hospital laboratory.

“I was a generalist, which means I was in charge of urinalysis, chemistry, special chemistry, hematology, blood banking, coagulation, I think I got it all—phlebotomy, all that kind of stuff,” Harrison said.

But at age 25, she began to hear what sounded like people talking.

Six years ago, 53-year-old Corla Morgan noticed blisters forming on her neck and back.

“I couldn’t sleep because when I took my shirt off, if my shirt touched my skin, the skin just peeled off,” Morgan says. “I was in really horrible pain.”

The St. Louis Children's Hospital's logo, which replaces the 'n' in 'Children's' with an image of the Gateway Arch, is printed all over the hospital campus, including the entrance off Kingshighway Boulevard. Spokeswoman Abby Wuellner said the logo represe
File photo|Nassim Benchaabane | St. Louis Public Radio

Missouri hospitals are providing less charity care than they did before the Affordable Care Act, according to a report by the Missouri Hospital Association.

But that's not necessarily a sign that hospitals are being stingy. According to the report's authors, that means more people can pay their medical bills.

It’s indicative of more people having insurance,” said Dave Dillon, spokesperson for the MHA. “The numbers for 2015 show very good progress.”

Protesters disrupt the Missouri Senate on May 6, 2016.
Courtesy, Missouri Senate

It's a split decision in the trial of the so-called "Medicaid 23," a group of religious leaders who staged a protest in the Missouri Senate more than two years ago over lawmakers' refusal to expand Medicaid.

Twenty-two members of the group were found guilty of trespassing for not leaving the Senate gallery when ordered to do so by Capitol police. But they were found not guilty of obstructing the operations of the Senate. The case of one other member will be decided later.

Keith Carter, 53, waits to pick up a prescription for diabetes at Affinia Healthcare in St. Louis. Though he falls in the income gap, he's able to get his preventive care covered through Gateway to Better Health.
Durrie Bouscaren | St. Louis Public Radio

At any given time, a half dozen people sit in the waiting room at Affinia Healthcare in south St. Louis. Two parents coo over a new baby, while a group of older patients chat along the back wall.

53-year-old Keith Carter sits alone. An embroidered polo shirt and badge show he’s just come from work.

“I seem fit. Inside, it’s just breaking down like sawdust. I just keep it in motion,” he said, as he waited to pick up a prescription to manage his diabetes.

Gov. Jay Nixon made expanding Medicaid a top priority when he first ran for governor. While he made some small steps, he was largely unsuccessful in achieving that goal.
File photo by Carolina Hidalgo I St. Louis Public Radio

After Gov. Jay Nixon placed his signature on legislation that could expand Medicaid for Missourians who are disabled or elderly, I couldn’t help but think back to when the Democratic official visited Bob Pund’s apartment.

Nixon was a mere attorney general when he ventured into Pund’s residence back in 2007. Pund is paralyzed from the shoulders down and had been critical of major cuts made to Medicaid in 2005. As Nixon sat in Pund’s living room, the aspiring governor vowed to make reversing those reductions a priority of his eventual administration – even if he was faced with a Republican-controlled legislature.

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